Whatever else you’re doing this socially-distanced Easter long weekend, the authors below have a message for you.
There’s never been a better time to give up smoking.
To be fair, it’s always a good time to stop, but they make the argument that, far from driving smokers to increase their consumption, the spectre of COVID-19 should be a driver to quit.
Read on for the rationale, and for some tips on the many resources available for smokers to turn pandemic anxiety into a chance to take back one aspect of your health that is completely within your control.
Billie Bonevski, Eliza Skelton and Caitlin Bialek write:
The battle against tobacco use has never been more important. There is good evidence to suggest that people who smoke are at increased risk of the new coronavirus COVID-19 that, as of 8 April 2020, has infected 1.4 million people and killed 79 000.
Early data from China showed that smoking history increased odds of COVID-related pneumonia. Now more recent data from the UK and Italy also make associations between smoking and COVID-19 severity of symptoms.
Overall, the case for smoking leading to worse outcomes with COVID-19 disease is growing stronger.
Other factors that are linked to COVID-19 symptom severity are age and comorbidities. This means that having a chronic illness like cardiovascular disease, cancer, diabetes or chronic respiratory diseases may result in more severe disease and even higher rates of deaths.
People who smoke have higher rates of these chronic diseases further complicating recovery from COVID-19.
Smoking can also increase your chances of contracting COVID-19. The hand-to-mouth action of smoking is problematic at a time when people are being advised to avoid touching their face.
Why quit now?
It’s not too late to quit smoking. The body starts to repair itself almost immediately.
First, people who quit smoking notice differences in their senses of smell and taste which are dulled by smoking. Interestingly, data on COVID-19 is suggesting that impairment of people’s ability to smell and taste are early indicators that you may have the disease.
Being able to distinguish the range of your taste and smell may be important in recognising symptoms, and quitting smoking will help you do that within weeks.
Then within months of quitting your lung function will start to recover. This is important because COVID-19 attacks the lungs – people with COVID-19 related cough and shortness of breath have usually developed an infection in the passages that conduct air between the lungs and the outside world.
As the respiratory system becomes increasingly infected, there is a build up of inflammatory materials (e.g., fluid) in the lungs leading to pneumonia. However, within a few months
of quitting smoking, the tiny hairs called the cilia, that help clear mucus and other material from the lungs work more efficiently.
Smoking also affects people’s immune system. People who may be immunosuppressed such as those on cancer treatment or on some autoimmune disorder medications are at increased risk of COVID-19 complications. Quitting smoking will assist the body’s ability to fight the virus.
In this article we address some of the challenges people might be facing trying to quit smoking during a pandemic which requires people to stay at home, may limit access to health professionals, and may be associated with significant financial stress and even mental ill-health.
Quitting smoking during physical distancing and a lockdown
Staying at home and limiting any outdoor activity or travel to only what is essential poses a risk for both people who smoke and the people who live with them.
Exposure to second-hand-smoke increases the risk of acute respiratory infections for the non-smokers. Children who are currently at home with adults who smoke are at risk of second-hand-smoke. If people are unable or unwilling to quit, they should smoke outside the home.
While some people are able to quit through force of will alone, many require assistance. Data show that getting assistance to quit smoking significantly improves people’s chance of success and length of staying quit.
Using both stop smoking medications and receiving some behavioural counselling is the most effective quit support. However, both may be difficult to access during distancing and lockdown situations.
People who smoke do have options to assist them in receiving this care. Online pharmacies are available and can deliver the medications to a person’s home. For example, most forms of nicotine replacement therapy (which aim to replace the nicotine people crave in cigarettes), do not need a doctor’s prescription and can be purchased online. They are also available in supermarkets and pharmacies.
The government in Australia has extended telehealth access meaning that people are able to receive their prescriptions as well as quit smoking counselling over the phone.
Each state and territory in Australia has telephone Quitlines that provide expert and effective telephone based quit support for free. Quitlines have dedicated counsellors for callers who are Aboriginal or pregnant, and provide multi-language services.
Online programs such as the NSW-based iCanQuit program and MyQuitBuddy mobile phone app are available for people who prefer digital options. For women who are pregnant, the Quit for You Quit for Two app is available to upload for free.
Maintaining good mental health while quitting smoking during COVID-19
Many people will be experiencing financial stress during this time, and others may be anxious and worried about COVID-19. There is data that shows that people find it harder to quit when they are experiencing even mild mental health concerns.
However research shows that people who have quit smoking report less stress, anxiety, and depression and improved quality of life. The Black Dog Institute has released strategies for dealing with anxiety during COVID-19 and Beyond Blue has rapidly opened a new mental health service for COVID-19.
These strategies help people with working from home and social isolation.
With the high cost of cigarettes in Australia at present, quitting smoking will also improve financial hardship and stress.
It is important to continue receiving support for good mental health. Addressing any alcohol or other drug related issues is also important to ensure ongoing safety for the people within a household.
There are numerous resources available online and through telehealth for mental health care and addressing substance use. Some mental health professionals are providing video conferencing consultations, which clients with the computer resources are able to take advantage of for quit support as well.
While physical distancing measures increase the difficulty of maintaining positive relationships, they also provide an opportunity for people who smoke “socially”.
Instead of smoking with a few friends over drinks or a coffee, why not try some self-care options instead like home yoga, or Houseparty gatherings online to catch up with friends, providing some social support while trying to quit.
Globally, 1.1 billion people smoke. The impact of COVID-19 could be lessened if that number of smokers is reduced. Despite restricted access to care, quit support is available.
Professor Billie Bonevski is a NHMRC Career Development Fellow, Behavioural Scientist, and University of Newcastle and HMRI researcher whose smoking cessation programs are being implemented by Cancer Councils across the nation. Dr Eliza Skelton is a Research Academic at the School of Medicine and Public Health, University of Newcastle. Caitlin Bialek, is a Research Assistant at the School of Medicine and Public Health, University of Newcastle.
